Bethany Cliffe, Abigail Croker, Megan Denne, Jacqueline Smith and Paul Stallard 2019. Preprint: Digital cognitive behaviour therapy for insomnia (CBTi) for adolescents with mental health problems. Results from a feasibility open trial. JMIR Publications. https://doi.org/10.2196/preprints.14842
| Title | Preprint: Digital cognitive behaviour therapy for insomnia (CBTi) for adolescents with mental health problems. Results from a feasibility open trial |
|---|---|
| Authors | Bethany Cliffe, Abigail Croker, Megan Denne, Jacqueline Smith and Paul Stallard |
| Description | Background: Insomnia in adolescents is common, persistent, and associated with poor mental health including anxiety and depression. Insomnia in adolescents attending child mental health services is seldom directly treated and the effects of digital CBTi on the mental health of adolescents with significant mental health problems is unknown. Objective: This paper reports an open study assessing the feasibility of adding supported online CBT for insomnia to the usual care of young people aged 14-17 years attending specialist child and adolescent mental health services. Methods: Thirty-nine adolescents aged 14-17 attending specialist child and adolescent mental health services with insomnia were assessed and offered digital CBTi. The digital intervention was Sleepio, an evidence based, self-directed, fully automated CBTi that has proven effective in multiple randomized controlled trials with adults. Self-report assessments of sleep (Sleep Condition Indicator, Insomnia Severity Scale, online sleep diaries), anxiety (Revised Child Anxiety and Depression Scale) and depression (Mood and Feelings Questionnaire) were completed at baseline and post-intervention. Post-use interviews assessed satisfaction with digital CBTi. Results: Average baseline sleep efficiency was very poor (52.9%) with participants spending an average of 9.6 hrs in bed but only 5.1 hrs asleep. All scored <17 on the Sleep Condition Indicator with 36/39 (92.3%) scoring ≥15 on the Insomnia Severity Scale, suggesting clinical insomnia. 36 (92.3%) scored ≥ 27 on the Mood and Feelings Questionnaire for major depression and 20 (51.3%) had clinically elevated symptoms of anxiety. The majority (76%) were not having any treatment for their insomnia, with the remaining 24% receiving medication. Sleepio was acceptable with 77% (30/39) activating their account and 67% (21/30) completing the program. Statistically significant pre-post improvements were found in weekly diaries of sleep efficiency (p=.005) and sleep quality (p=.001) and on measures of sleep (SCI; p=.001: ISI; p=.001), low mood (MFQ; p=.024) and anxiety (RCADS; p=.015). Satisfaction was high; with 89% finding Sleepio helpful, 94% would recommend it to a friend with 39% expressing a definite preference for a digital intervention. Conclusions: Our study has a number of methodological limitations, particularly the small sample size, absence of a comparison group and follow-up assessment. Nonetheless, our findings are encouraging and suggest that digital CBTi for young people with mental health problems might offer an acceptable and an effective way to improve both sleep and mental health. Clinical Trial: N/a |
| Year | 2019 |
| Output media | JMIR Preprint |
| Publisher | JMIR Publications |
| Publication dates | |
| Published online | 29 May 2019 |
| Digital Object Identifier (DOI) | https://doi.org/10.2196/preprints.14842 |
| Web address (URL) | https://doi.org/10.2196/preprints.14842 |